Organization · NPI-2

617 Primary Care PLLC

Family Medicine · Cambridge, MA

NPI number1629925425
StatusActive
Last updated in NPPESMar 12, 2026

Details

NPI
1629925425
Entity type
Organization (NPI-2)
Legal business name
617 Primary Care PLLC
Organization subpart
No
Enumeration date
Mar 12, 2026
Certification date
Mar 12, 2026
Last updated
Mar 12, 2026

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family Medicine––Yes

Practice location

777 Concord Ave Ste 105
Cambridge, MA 02138-1053

Phone 617-675-4085 · Fax 617-360-3163

Mailing address

777 Concord Ave Ste 105
Cambridge, MA 02138-1053

Phone 617-675-4085 · Fax 617-360-3163

Authorized official

Paulius Mui
Owner
6178406340

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